Diare Dermatology LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

26NJ00625200 Issued in NJ

Legal business name

DIARE DERMATOLOGY LLC

Practice address

45 South Ave W
Cranford, NJ 07016

Phone

(908) 420-1361

NPI assigned

May 8, 2018

Last updated

May 18, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle ItidiareNPI 1194180349

Title

Owner

Phone

(908) 420-1361

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Itidiare

  • Family Nurse Practitioner
  • West Orange, NJ
  • NPI 1194180349
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1366931032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SOUTH AVE W STE 102",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162686",
            "telephone_number": "908-420-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SOUTH AVE W",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "07016",
            "telephone_number": "908-420-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIARE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "ITIDIARE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-420-1361"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "26NJ00625200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "26NJ00625200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Miriam Denigris, RDN
• Dent D' Elite LLC
• Diana Deserto, MA, CF-SLP
• Alexa Dewey
• Diane Stanley LCSW LLC
• Sabrina G. Dicosmo, MA, LPC
• Lauren Dignazio, CCC-SLP
• Nicholas R Dignazio
• Elizabeth Perlman Diluccio, SLP
• Arianna Nicole Diraggio, LSW

• Clinic/Center in Cranford, NJ
• Providers in Cranford, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.